Provider Demographics
NPI:1235262791
Name:ALOHA WELLNESS INC.
Entity Type:Organization
Organization Name:ALOHA WELLNESS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMONA
Authorized Official - Middle Name:T
Authorized Official - Last Name:SILVA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:505-401-9786
Mailing Address - Street 1:2100 SAN VENITO RD NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87104-2578
Mailing Address - Country:US
Mailing Address - Phone:505-401-9786
Mailing Address - Fax:505-401-9786
Practice Address - Street 1:1301 LOMAS BLVD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87104-1201
Practice Address - Country:US
Practice Address - Phone:505-401-9786
Practice Address - Fax:505-401-9786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM711103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM92782850Medicaid
NM10013069Medicare UPIN
NM92782850Medicaid